Healthcare Moves from the Election and Back to Congress

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.

November 19, 2018 - 17:11 — Elizabeth Wright

Poll, after poll, after poll shows that healthcare was the top issue in the 2018 elections. This should not be a surprise as Democrats ran on the issue, while many Republicans hid from it.

That’s too bad because the Trump administration has been doing a lot via regulations and guidance to create more choices and drive down premium costs for Americans. And since mid-summer, there has been a plan, called the Healthcare Choices Proposal, designed by free-market policy wonks and written by Senate staff, under the auspices of Sens. Bill Cassidy (R-La.) and Lindsey Graham (R- S.C.). The plan would take healthcare decisions out of Washington and return it to the states, while providing substantial funding to help people with pre-existing conditions and those with low-incomes.

The Trump administration expanded the use of short-term, limited-duration health insurance that will help many individuals obtain affordable plans. Under Section 1332 of the Patient Protection and Affordable Care Act (ACA), better known as Obamacare, the administration is allowing states to come up with innovative ways to fix the healthcare market in their states that was devastated by Obamacare. The 1332 innovation waivers have already been utilized, such as in Alaska, where federal subsidies were used to fund a reinsurance program that stabilized markets, brought down premiums, and helped those with pre-existing conditions.

In October 2018, the administration offered new guidance on Sec. 1332 waivers, that will supersede guidance written during the Obama administration and will allow more flexibility for the states to design plans that will help their citizens.

As for the congressional action, CAGW has written about the Healthcare Choices Proposal in other blogs. Essentially, the proposal would take all the money currently being spent on insurance companies and send it back to the states in the form of federal grants. The funding would be used to help those with pre-existing conditions and assist low-income individuals get access to healthcare. Regulatory power would be moved out of Washington, D.C. and back to the states where government is closer to the people.

It is unlikely that the Healthcare Choices Proposal will get beyond the Senate, which is ironic since it was in this august body where Republican healthcare reform died in 2017 and opened the door to it being a 2018 election issue. Healthcare is not dead, though.

Democrats made healthcare a big issue in this year’s election by accusing Republicans of wanting to end coverage for those with pre-existing conditions. This was and is a false narrative. Ranking-member Pelosi, should she become Speaker of the House, and the Democratic leadership would like to fix Obamacare, but according to a November 10, 2018 Washington Times article, a majority of rank-and-file Democrats want Sen. Bernie Sander’s Medicare for All. That legislation would force everyone into the same single-payer healthcare system. Sanders claims if his proposal was adopted, it would provide "free" healthcare for everyone and only cost $1.38 trillion a year. CAGW wrote about this dubious proposal in an August blog. It is worth remembering these are the same politicians that promised Obamacare would save families $2,500 a year and you would be allowed to keep your doctor and healthcare plan. We all know how that worked out.

Since congress is divided, chances are slim any legislation will be passed by both chambers and sent to the president for his signature, but Republican members of Congress and their staff need to get up to speed on healthcare because there will be a long debate on this important issue. Should we adopt a single-payer system, like those seen overseas that ration care and stifle innovation? Or should we look to the Healthcare Choices Proposal that will take healthcare decision-making away from unelected D.C. bureaucrats and return it closer to the people? It is only a matter of time when that choice will be made.